HPS Weekly Report
11 Dec 2018
Volume 52 No. 49
HPS immunisation web page quarterly updates
Update on international spread of wild poliovirus
The 19th meeting of the Emergency Committee under the International Health Regulations (IHR) (2015), regarding the international spread of wild poliovirus (WPV), was convened by World Health Organization (WHO) Director-General Dr. Tedros Adhanom Ghebreyesus on 27 November 2018.
The committee agreed that the situation still constitutes a Public Health Emergency of International Concern (PHEIC) and recommended the extension of the temporary recommendations for a further three months. The committee provided the Director-General with updated risk categories as shown below.
States infected with WPV1 with potential risk of international spread:
States infected with circulating vaccine-derived polio virus (cVDPV):
- Democratic Republic of Congo
- Papua New Guinea
States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV:
- Central African Republic
TRAVAX recommends polio vaccination within 10 years for travel to countries where it is three years or less since the last case, for:
- Lao People’s Democratic Republic
In addition, in order to comply with the WHO and European Centre for Disease Prevention and Control (ECDC) recommendations, and also to avoid travellers being vaccinated in the polio-infected country, authorities in the UK have made a range of more detailed recommendations.
ECDC issues migrant screening and vaccination guidance
The European Centre for Disease Prevention and Control (ECDC) has published ‘Public health guidance on screening and vaccination for infectious diseases in newly arrived migrants within the EU/EEA’ which provides scientific advice, based on an evidence-based assessment of targeted public health interventions, to facilitate effective screening and vaccination for priority infectious diseases among newly arrived migrant populations to the EU/EEA.
Migrants do not generally pose a health threat to the host population. However, some subgroups of migrants, including refugees, asylum seekers, and irregular migrants, are particularly vulnerable to infectious diseases and may have worse health outcomes than the host population. In a number of EU/EEA Member States, subgroups of migrant populations are disproportionately affected by infectious diseases such as tuberculosis, HIV, and hepatitis B and C.
The report suggests that it is likely to be both effective and cost-effective to screen child, adolescent and adult migrants for active and latent tuberculosis, HIV, hepatitis C, hepatitis B, strongyloidiasis and schistosomiasis. It also suggests that there is a clear benefit to enrolling migrants in vaccination programmes and ensuring catch-up vaccination where needed.
Source: ECDC, 5 December 2018
Campylobacter levels remain steady
On 8 December 2018, the Food Standards Agency (FSA) noted that the top nine retailers across the UK have published their latest testing results on Campylobacter contamination in UK-produced fresh whole chickens (covering samples tested from July to September 2018).
The latest figures show that on average, across the major retailers, 3.5% of chickens tested positive for the highest level of contamination. These are the chickens carrying more than 1,000 colony forming units per gram (cfu/g) of Campylobacter. The corresponding figure for the previous set of results (April - June 2018) was 3.7%, while for the first publication (July - September 2017) it was 4.6%.
The FSA has been testing chickens for Campylobacter since February 2014 and publishing the results as part of a campaign to bring together the whole food chain to tackle the problem. Campylobacter is the most common cause of food poisoning in the UK.
Since September 2017, major retailers have carried out their own sampling and published their results under robust protocols laid down by the FSA.
Source: FSA News, 7 December 2018
Bluetongue virus detected in imported animals
The UK’s Chief Veterinary Officer has urged farmers to increase their vigilance for Bluetongue virus after the disease was picked up and dealt with in three consignments of cattle imported from France.
Two consignments were brought to two separate premises in Yorkshire, where the disease was identified as a part of routine post-import testing. All infected cattle, plus one other animal which travelled in the same vehicle and was found to be susceptible to infection, will be humanely culled.
The third consignment was taken to a premises in Northern Ireland where the disease was detected by the Department of Agriculture, Environment and Rural Affairs (DAERA).
Bluetongue does not affect people or food safety, but outbreaks of the virus can result in restrictions on livestock movement and trade. The virus is transmitted by midge bites and affects cattle, goats, sheep and other camelids such as llamas. It can reduce milk yield and cause infertility and in the most severe cases is fatal for infected animals.
Action is being taken to ensure the risk of spread of the disease is reduced, with movement restrictions already in place at the affected premises.
Importers should be aware that all cattle and sheep arriving in the UK from countries where Bluetongue is known to be circulating will be restricted until post-import testing is carried out and the animals are confirmed as compliant. Any animals which are infected with Bluetongue will be culled and no compensation will be paid. Any animals in the consignment which are at risk of becoming infected may also be culled.
All other susceptible animals on the premises will be placed under movement restrictions until it can be confirmed that the disease has not spread.
Following the interception of these consignments, the UK remains officially Bluetongue-free, the risk of the disease remains low and exports are not affected.
Scottish Government consultation on Transportation Noise Action Plan
The Environmental Noise Directive (END) was adopted in 2004 and requires member states to bring about measures which are intended to avoid, prevent or reduce, on a prioritised area basis, the harmful effects, including annoyance due to the exposure to environmental noise. The Directive was transposed through the Environmental Noise (Scotland) Regulations 2006
This consultation applies to Scotland only and seeks the views of those individuals and organisations that hold an interest in noise pollution from roads and railways.
The consultation closes on 16 January 2019, after which the responses will be evaluated and where appropriate the draft noise action plans amended. It is anticipated that the noise action plans will be formally approved early in 2019.
More information and the online consultation response form are available on the Scottish Government website
Best practice for after-action reviews to enhance public health preparedness
An integral part of improving preparedness and response planning is to learn from past public health emergencies. Conducting after-action reviews (AARs) is one way of capturing learning, but there is no standardised approach to conducting such assessments. In order to support public health practitioners in making the best use of AARs, the European Centre for Disease Prevention and Control (ECDC) has published 'Best practice recommendations for conducting after-action reviews to enhance public health preparedness' which identifies common features of AARs, provides a validity assessment tool to appraise them, and proposes a set of best practice recommendations.
The report does not recommend a single best AAR methodology for the purposes of preparedness planning. Instead it outlines key stages, good practice and minimum standard dimensions to consider when planning and undertaking an AAR, alongside 11 validity-boosting recommendations that every AAR practitioner should consider to improve the use of AAR methodology.
Health and climate change
A report launched by the World Health Organization (WHO) at the United Nations Climate Change Conference (COP24) in Katowice, Poland, on 5 December 2018, highlights why health considerations are critical to the advancement of climate action and outlines key recommendations for policy makers.
WHO’s ‘COP24 special report: health and climate change’ provides recommendations for governments on how to maximize the health benefits of tackling climate change and avoid the worst health impacts of this global challenge.
It describes how countries around the world are now taking action to protect lives from the impacts of climate change, but that the scale of support remains inadequate, particularly for the small island developing states, and least developed countries. Only approximately 0.5% of multilateral climate funds dispersed for climate change adaptation have been allocated to health projects.
The report calls for countries to account for health in all cost-benefit analyses of climate change mitigation. It also recommends that countries use fiscal incentives such as carbon pricing and energy subsidies to incentivise sectors to reduce their emissions of greenhouse gases and air pollutants. It further encourages parties to the United Nations Framework Convention on Climate Change (UNFCCC) to remove existing barriers to supporting climate-resilient health systems.
The COP24 conference documents, papers and presentations papers are all available on the United Nations Climate Change website
Source: WHO, 5 December 2018